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[2] [3] Mastoiditis is usually caused by untreated acute otitis media (middle ear infection) and used to be a leading cause of child mortality. With the development of antibiotics, however, mastoiditis has become quite rare in developed countries where surgical treatment is now much less frequent and more conservative, unlike former times. [2]
The constellation of symptoms was first described as a consequence of severe, advanced ear infection which has spread to a central portion of the temporal bone of the skull. This type of presentation was common prior to development of antibiotic treatments, and is now a rare complication.
A mastoidectomy is a procedure performed to remove the mastoid air cells [1] near the middle ear. The procedure is part of the treatment for mastoiditis, chronic suppurative otitis media or cholesteatoma. [2] Additionally, it is sometimes performed as part of other procedures, such as cochlear implants, [3] or to access the middle ear.
Independent sector treatment centres (ISTCs) are private-sector owned treatment centres contracted within the English National Health Service to treat NHS patients free at the point of use. They are sometimes referred to as 'surgicentres' or 'specialist hospitals'.
Mastoiditis* Children History of URI >10 days Recent history of URI or ear infection Fevers/chills May see signs of otitis media on exam Pain is located behind the ear with postauricular (i.e. near mastoid process) swelling* Diagnose with CT Chronic suppurative otitis media: Conductive hearing loss Relapsing/remitting or chronic discharge
Bezold's abscess is an abscess deep to the sternocleidomastoid muscle where pus from mastoiditis erodes through the cortex of the mastoid part of the temporal bone, medial to the attachment of sternocleidomastoid, extends into the infratemporal fossa, and deep to the investing layer of the deep cervical fascia.
This treatment cannot reverse conductive hearing loss, but may slow the progression of both the conductive and sensorineural components of the disease process. Otofluor, containing sodium fluoride, is one treatment. Recently, some success has been claimed with a second such treatment, bisphosphonate medications that inhibit bone destruction.
Infections in the middle ear easily spread into the mastoid air cells through the aditus ad antrum, resulting in mastoiditis, a potentially dangerous and life-threatening condition. Infection may then further spread into the middle cranial fossa or posterior cranial fossa, causing meningitis or abscess of adjacent brain tissue.